https://scholars.lib.ntu.edu.tw/handle/123456789/485668
標題: | Interobserver variability in target definition for hepatocellular carcinoma with and without portal vein thrombus: Radiation therapy oncology group consensus guidelines | 作者: | Hong T.S. Bosch W.R. Krishnan S. Kim T.K. Mamon H.J. Shyn P. Ben-Josef E. Seong J. Haddock M.G. CHIA-HSIEN CHENG Feng M.U. Stephans K.L. Roberge D. Crane C. Dawson L.A. |
公開日期: | 2014 | 出版社: | Elsevier Inc. | 卷: | 89 | 期: | 4 | 起(迄)頁: | 804-813 | 來源出版物: | International Journal of Radiation Oncology Biology Physics | 摘要: | Purpose Defining hepatocellular carcinoma (HCC) gross tumor volume (GTV) requires multimodal imaging, acquired in different perfusion phases. The purposes of this study were to evaluate the variability in contouring and to establish guidelines and educational recommendations for reproducible HCC contouring for treatment planning. Methods and Materials Anonymous, multiphasic planning computed tomography scans obtained from 3 patients with HCC were identified and distributed to a panel of 11 gastrointestinal radiation oncologists. Panelists were asked the number of HCC cases they treated in the past year. Case 1 had no vascular involvement, case 2 had extensive portal vein involvement, and case 3 had minor branched portal vein involvement. The agreement between the contoured total GTVs (primary + vascular GTV) was assessed using the generalized kappa statistic. Agreement interpretation was evaluated using Landis and Koch's interpretation of strength of agreement. The S95 contour, defined using the simultaneous truth and performance level estimation (STAPLE) algorithm consensus at the 95% confidence level, was created for each case. Results Of the 11 panelists, 3 had treated >25 cases in the past year, 2 had treated 10 to 25 cases, 2 had treated 5 to 10 cases, 2 had treated 1 to 5 cases, 1 had treated 0 cases, and 1 did not respond. Near perfect agreement was seen for case 1, and substantial agreement was seen for cases 2 and 3. For case 2, there was significant heterogeneity in the volume identified as tumor thrombus (range 0.58-40.45 cc). For case 3, 2 panelists did not include the branched portal vein thrombus, and 7 panelists contoured thrombus separately from the primary tumor, also showing significant heterogeneity in volume of tumor thrombus (range 4.52-34.27 cc). Conclusions In a group of experts, excellent agreement was seen in contouring total GTV. Heterogeneity exists in the definition of portal vein thrombus that may impact treatment planning, especially if differential dosing is contemplated. Guidelines for HCC GTV contouring are recommended. ? 2014 Elsevier Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903176251&doi=10.1016%2fj.ijrobp.2014.03.041&partnerID=40&md5=eb0631e1a829533c2c30b21cec2c4534 https://scholars.lib.ntu.edu.tw/handle/123456789/485668 |
ISSN: | 0360-3016 | DOI: | 10.1016/j.ijrobp.2014.03.041 | SDG/關鍵字: | Computerized tomography; Tumors; Computed tomography scan; Gross tumor volume; Hepatocellular carcinoma; Interobserver variability; Methods and materials; Multi-modal imaging; Radiation oncologists; Radiation therapy oncology groups; Blood vessels; alpha fetoprotein; sorafenib; adult; aged; cancer size; case report; computer assisted tomography; female; human; liver cell carcinoma; male; middle aged; nuclear magnetic resonance imaging; portal vein; portal vein thrombosis; practice guideline; priority journal; radiation oncologist; review; stereotactic body radiation therapy; treatment planning; tumor thrombus; Aged; Algorithms; Carcinoma, Hepatocellular; Consensus; Female; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Observer Variation; Portal Vein; Reproducibility of Results; Tomography, X-Ray Computed; Tumor Burden; Uncertainty; Venous Thrombosis |
顯示於: | 腫瘤醫學研究所 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。